Conjeevaram, Srinivasulu
Conjeevaram, Srinivasulu is an individual health care provider with primary practice located at 100 Linwood Ave Ste 2A , Colchester CT 06415-1138. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Conjeevaram, Srinivasulu can be contacted via phone (860) 415-3622.Contact Information
Primary practice address
100 Linwood Ave Ste 2A
Colchester CT 06415-1138
Phone: (860) 415-3622
Fax: (860) 974-0884
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 53644 | Connecticut |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 4301086842 | Michigan |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 53644 | Connecticut |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 53644 | Connecticut |
Profile Details
| NPI number | 1780958058 |
|---|---|
| LBN Legal business name | Conjeevaram, Srinivasulu |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 2nd, 2012 |
| Last updated | Mar 24th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780958058 | NPPES |
| Connecticut | Other | 053644 | STATE MEDICAL LICENSE |
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